Good Long-term Outcomes after Repair of Chronically Displaced Medial Meniscus Bucket-handle Tears

Abstract

Abstract Background: Meniscal repair in bucket-handle tears has proven to be effective. However, when such lesions are chronically displaced and adhered to intercondylar soft tissues, their repair may be considered unfeasible. Accordingly, the objective of this study is to show the surgical technique for the reduction and repair of this type of injury and to evaluate the long-term outcomes of such repairs. Materials and Methods: We conducted a retrospective case series of eight patients who were identified between 2006 and 2015 and presented with chronically displaced, medial meniscus bucket-handle tears. The bucket-handle tears were reduced, and the medial meniscus was repaired in all cases. The knee was immobilized in full extension and maintained nonweight bearing for 2 weeks. Then, the range of movement was limited from 0° to 90° and kept partially weight bearing for 4 more weeks. Results: The mean age of the patients was 27.2 years. The mean time to surgery was 7.12 ± 4.4 months, and the mean follow-up time was 10.0 ± 3.4 years. The average preoperative and postoperative Lysholm score was 58.0 ± 16.2 and 95.9 ± 3.4, respectively (P = 0.008). The mean preoperative and postoperative Tegner was 5.5 ± 1.1 and 5.1 ± 1.1, respectively (P = 0.109). The average KT-1000 of the participants was 1.2 ± 1.2, and the mean International Knee Documentation Committee was 92.9 ± 5.0. The average Ählback score at follow-up was 0.83 ± 0.4. Conclusions: The treatment of chronically dislocated bucket-handle tears can be successfully achieved by the sequential release and suture of the torn meniscus. Good outcomes and low rates of osteoarthritis were observed at 10-year follow-up. Level of Evidence: IV